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A Novel Cervical Sagittal Classification for Asymptomatic Population Based on Cluster Analysis.

Zhaoyang Gong1, Haocheng Xu1, Yong Yang2

  • 1Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.

Clinical Spine Surgery
|April 19, 2024
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Summary

A new classification system for cervical sagittal alignment in asymptomatic individuals was developed. This method is simple, reliable, and helps understand variations in cervical spine alignment.

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Area of Science:

  • Orthopedics
  • Radiology
  • Spine Surgery

Background:

  • Cervical spine sagittal morphology exhibits significant individual variation.
  • A standardized classification for cervical sagittal alignment is currently lacking.

Purpose of the Study:

  • To introduce a novel classification system for cervical sagittal alignment in asymptomatic individuals.
  • To enhance the understanding of normal cervical sagittal alignment variations.

Main Methods:

  • A cross-sectional study involving 183 asymptomatic subjects.
  • Measurement of global and segmental cervical sagittal parameters.
  • Development of a novel classification based on cluster analysis and defined parameter ranges, validated for reliability and compared to existing methods.

Main Results:

  • Four subtypes proposed: Large Lordosis (LL), Small Lordosis (SL), Straight (S), and Kyphosis (K).
  • The novel classification demonstrated high inter-observer (ICC=0.856) and intra-observer (ICC=0.851-0.913) reliability, with significantly reduced measurement time compared to the Toyama method.
  • SL was the most prevalent subtype (37.7%), with variations in subtype distribution observed across sex and age.

Conclusions:

  • A novel, simple, and reliable cervical sagittal classification for asymptomatic populations has been successfully proposed.
  • This classification system aids in understanding the spectrum of normal cervical sagittal alignment.